icici pru pos - life raksha you have a period of 15/30 ...€¦ · 2. cheques 3. demand drafts 4....

ICICI Prudential Life Insurance Company Ltd. of 23 Filing Date: February 12, 2018

ICICI Pru POS - Life Raksha

A non-participating non-linked term insurance

plan

PART A - Welcome Letter

Dear <Customer Name>,

This is your life insurance policy. It is a legal document.

Please read it carefully.

We have highlighted some important points regarding

your policy that you should keep in mind:

1. YOUR POLICY DETAILS

Name of your plan : <<Product Name>>

Policy Number : <Policy Number>

Mobile Number : <Mobile Number>

Email ID : <Email ID>

Sum Assured (Insurance Cover Amount) (in `) :<Amount>

Premium Instalment (in `) : <Amount>

Payment frequency : <Payment Frequency>

Next premium due date : <Date>

You need to pay premiums for : PPT in years

Policy term : <Policy term> years

Policy end date: <Date of Maturity>

In case of any discrepancies in the above details please

inform us immediately.

You have purchased your policy from

Name : <Advisor Name>

Code / License Number : <Advisor Code>

PAN : <ID Number>

Aadhaar Number : <ID No.>

Contact Number : <Advisor Contact>

Address : <Advisor address>

2. YOUR FREE LOOK PERIOD

You have a period of 15/30 days* to review your policy

from the date you receive it. In this period you can

return the policy to us with reasons for cancellation.

We will refund the premium paid after deduction of

Stamp duty and proportionate risk premium.

*30 days free look period is applicable only for

electronic policies or policies sourced through

distance marketing. For complete definition of

Distance Marketing, please refer to Part B of the policy

document.

3. MAKING A CLAIM

We may be contacted on 1-860-266-7766 for any

claims to be made under the policy and we will assist

the claimant through the entire process.

In case of any queries or clarifications required, please feel free to contact your advisor or reach us at any of our service

centres mentioned below. We will be happy to assist you. Warm regards,

<<< Authorised Signatory>>> Visit us at

<<< Designation >>> www.iciciprulife.com

Write to us at: Email us at: Customer Service Helpline

ICICI Prudential Life Insurance Co. Ltd. [email protected] 1860 266 7766

Ground Floor & Upper Basement,

Unit No. 1A & 2A, Raheja Tipco Plaza,

Rani Sati Marg, Malad (East), Mumbai – 400097

Maharashtra

ICICI Prudential Life Insurance Co. Ltd. Registered Address: ICICI Pru Life Towers,

1089, Appasaheb Marathe Marg, Prabhadevi, Mumbai -400025

Reg No. :105. Insurance is the subject matter of solicitation.

Unique Identification Number as specified by IRDAI XXXXXXXXXX

http://www.iciciprulife.com/

mailto:[email protected]

ICICI Prudential Life Insurance Company Ltd of 23 Filing Date: February 12, 2018

Policy Certificate - ICICI Pru POS - Life Raksha - <UIN>

(This is a non-participating non-linked term insurance plan)

This Policy is the evidence of a contract between ICICI Prudential Life Insurance Company

Limited (Us/We/ Company) and the Policyholder referred to below (You).

This Policy is issued on the basis of the details provided by You in the Proposal Form

submitted along with the required declarations, personal statement, applicable medical

reports, the first premium deposit and any other information and documentation which

constitute evidence of the insurability of the Life Assured for the issuance of the Policy.

We agree to provide the benefits set out in this Policy subject to its terms and conditions.

Name of the Life Assured:

Address: Category: Medical/Non-Medical

Date of Birth: Age (Years): Age Admitted: Y/N

Name of the Policyholder:

Policy No: Policy Commencement Date:

Risk Commencement Date: Date of Maturity/Termination:

Policy Term in years: Premium payment option:

Premium Payment Term (PPT) in years: Due date of last premium payable:

Periodicity of payment of premium (premium

frequency): Premium instalment (Rs.):

Sum Assured (Rs.): Policy sourced by Distance

Marketing: Y/N

Nominee (Name): Nominee’s Relationship with the

Life Assured:

Nominee Age: Appointee (Name):

Goods and Services Tax and/or cesses would be charged extra, as applicable.

Policy Certificate, terms and conditions of the Policy and the endorsements by Us, if

any, shall form an integral part of this contract and shall be binding on Us and You.

The Policy shall stand cancelled by Us, without any further notice, in the event of dishonour

of the first premium deposit.

Please immediately inform Us about any change in address or contact details.

Signed for and on behalf of the ICICI Prudential Life Insurance Company Limited, at Head

Office, Mumbai on ……. (Issue Date)

Authorised Signatory

Designation

Version ………

Stamp duty of Rs. …………….. (Rupees …………….Only) paid by Pay order, vide receipt

no. ……………… dated ……………...

This is an output of a digitally signed print file

Please examine the policy and approach Us immediately in case of any discrepancies

ICICI Pru POS - Life Raksha Annexure – Policy Document


PART _B

ICICI Pru POS - Life Raksha (UIN)

Non-participating non-linked term insurance Plan

Definitions

1. Age means age at last birthday.

2. Appointee means the person appointed by You and named in the Policy

Certificate. This is applicable only where the Nominee is minor.

3. Claimant means the person entitled to receive benefits as per the terms and

conditions of the policy and applicable laws, and includes the policyholder, the

nominee, the assignee, the legal heir, the legal representative(s) or the holder(s)

of succession certificate as the case may be.

4. Date of Inception is the Risk Commencement Date or the Policy Commencement

Date whichever is later.

5. Date of Maturity/ Termination means the date specified in the Policy Certificate

on which the term of the Policy ends and maturity benefit, if applicable, is

payable.

6. Death Benefit means the benefit, which is payable on death as specified in the

Policy document.

7. Distance Marketing means every activity of solicitation (including lead

generation) and sale of insurance products through the following modes: (i)

voice mode, which includes telephone-calling (ii) short messaging service

(SMS) (iii) electronic mode which includes e-mail, internet and interactive

television (DTH) (iv) physical mode which includes direct postal mail and

newspaper and magazine inserts and (v) solicitation through any means of

communication other than in person.

8. Grace Period means the time granted by Us from the due date for the payment

of premium, without any penalty / late fee, during which time the policy

continues with risk cover without interruption, as per the terms of the policy.

9. Insured Event is death of the Life Assured during the term of the policy.

10. Life Assured means the person named in the Policy Certificate on whose life

the Policy has been issued.

11. Nominee means the person named in the Policy Certificate who has been

nominated by You to receive the Death benefit.

12. Policy means this document, the Proposal Form, the Policy Certificate and any

additional information/document(s) provided to Us in respect of the Proposal

Form, and any endorsement issued by Us.

13. Policy Certificate means the policy certificate and any endorsements attached

to and forming part of this Policy.

14. Policyholder or the Proposer or You or Your means the owner of the Policy at

any point of time.

15. Premium Payment Term means the period specified in the Policy Certificate

during which Premium is payable.

16. Proposal Form means the form filled in and completed by You for the purpose

of obtaining insurance coverage under this Policy.

17. Regulator is the authority that has regulatory jurisdiction and powers over the

Company. Currently the Regulator is Insurance Regulatory and Development

Authority of India (IRDAI).

18. Regular Pay means premiums need to be paid regularly throughout the Policy

term.



19. Revival of the Policy means restoration of Policy benefits.

20. Revival Period means the period of two consecutive years from the due date

of the first unpaid premium, during which period You are entitled to revive the

Policy.

21. Risk Commencement Date means the date as specified in the Policy Certificate,

on which the insurance coverage under this Policy commences.

22. Sum Assured means the amount specified in the Policy Certificate

23. Surrender means complete withdrawal/termination of the Policy by You.

24. We or Us or Our or Company means ICICI Prudential Life Insurance Company

Limited.

25. You or Your means the policyholder of the Policy at any point of time.



PART C

Key benefits

1. Death benefit

i. On death of the Life Assured during the policy term, Death Benefit will

be payable, provided all due premiums have been paid.

Death Benefit = A or B or C, whichever is highest

ii. Where,

A = Sum Assured,

B = 10 times the annualised premium,

C = Minimum Death Benefit (MDB) equals 105% of total premiums paid

(excluding Goods & Services Tax and/ or cesses) till the date of death.

For the purpose of this provision, annualised premium shall be the

premium payable in a year excluding

applicable premium payment frequency loading, if any.

Applicable taxes such as Goods & Services Tax and/ or cesses

iii. Sum Assured is as chosen by you and as specified in the Policy

Certificate.

iv. On payment of Death Benefit the policy will terminate and all rights,

benefits and interests under the policy will stand extinguished.

v. Death Benefit may be taxable as per the prevailing tax laws.

2. Maturity Benefit/ Survival Benefit

No maturity/survival benefits are payable on survival of the Life Assured till Date

of Maturity/ Termination under this policy.

3. Premium payment

i. You are required to pay premiums for the entire policy term on the due

dates and for the amount mentioned in the policy certificate.

ii. Your premium payment frequency is mentioned on your policy certificate.

If agreed by Us you may change your premium payment frequency during

the Policy Term. Premiums under the policy can be paid in yearly, half-

yearly or monthly frequency.

iii. For Monthly frequency of premium payment, additional loading will be

applied to both the base premium and the extra mortality premium. The

additional loadings, expressed as a percentage of the premium will be as

given below.

Premium

paying

frequency

Discount / Loading

Yearly 0%

Half-yearly 0%

Monthly 5% loading unless the payment is made by direct debit



iv. Collection of advance premium shall be allowed within the same financial

year for the premium due in that financial year. However, where the

premium due in one financial year is being collected in advance in earlier

financial year, we may collect the same for a maximum period of three

months in advance from the due date of the premium. The premium so

collected in advance shall only be adjusted on the due date of the premium.

v. You are required to pay premiums for the entire policy term on each

premium due date or during the grace period that follows each premium

due date. The grace period is 30 days, if the frequency of premium payment

is yearly or half-yearly and 15 days if premium payment frequency is

monthly. Risk cover continues during the grace period. The Policy will lapse

and the cover will cease if you do not pay premiums either on the due date

or during the grace period.

vi. We are not under any obligation to remind you about the premium due date,

except as required by applicable regulations.

vii. You may pay premium through any of the following modes:

1. Cash *

2. Cheques

3. Demand Drafts

4. Pay Orders

5. Bankers Cheque

6. Internet facility as approved by the Company from time to time.

7. Electronic Clearing System

8. Credit or Debit cards held in your name

*Amount and modalities will be subject to Company rules and relevant

legislation/ regulation

viii. Any payment made towards first or renewal premium is deemed to be

received by Us only when it is received at any of our branch offices or

authorized collection points and after an official issued receipt is issued.

ix. Where premiums have been remitted otherwise than in cash, the

application of the premiums received will be conditional on the realization

of the proceeds of the instrument of payment.

x. If you suspend payment of premium for any reason whatsoever, we will not

be held liable. In such an event, benefits, if any, will be available only in

accordance with the policy terms and conditions.



PART D

1. Freelook Period

If you are not satisfied with the policy, you may cancel it by returning the policy

document to Us for cancellation with reasons within

15 days from the date you received it, if your policy is not purchased

through Distance marketing

30 days from the date you received it, if your policy is an electronic

policy or is purchased through Distance marketing

On cancellation of the policy during the freelook period, we will return the

premium paid subject to the deduction of:

a. Stamp duty paid under the policy.

b. Proportionate risk premium for the period of cover

The policy shall terminate on payment of this amount and all rights, benefits

and interests under this policy will stand extinguished.

2. Surrender

There is no surrender benefit under this plan.

3. Loans

We will not provide loans under this policy.

4. Suicide clause

In case of death due to suicide within 12 months:

i. from the date of inception of the policy, the nominee or beneficiary of the

Life Assured shall be entitled to 80% of the premiums paid, provided the

policy is in force or

ii. from the date of revival of the policy the nominee or beneficiary of the Life

Assured shall be entitled to an amount which is higher of 80% of the

premiums paid till the date of death or the surrender value as available on

the date of death.

On payment of this all rights, benefits and interests under the policy will stand

extinguished.

5. Revival

A policy, which has lapsed for non-payment of premium within the grace

period, may be revived subject to the following conditions:

The application for revival is made within 2 years from the due date of the first

unpaid premium and before the Maturity/ Termination date of policy. Revival

will be based on the prevailing Board approved underwriting policy.

You furnish satisfactory evidence of health of the Life Assured as required by

Us.



The arrears of premiums together with interest at such rate as the Company

may charge for late payment of premiums are paid. Revival interest rates will

be set monthly based on the prevailing yield on 10 year Government Securities.

The yield on 10 year Government Securities will be sourced from

www.bloomberg.com.

The revival of the policy may be on terms different from those applicable to the

policy before it lapsed for example, extra mortality premiums may be

applicable.

We reserve the right to not revive the policy, If permitted by the Board approved

underwriting policy. In that case, only the premiums paid towards the revival

of the policy shall be refunded without any interest.

The revival will take effect only on its being specifically communicated by Us

to You.

6. To whom benefits are payable

We will pay the benefits under the policy on death of the Life Assured either to

You or to the assignee(s) where the policy has been assigned as per Section 38

of the Insurance Act, 1938 as amended from time to time.

In case of Your death or death of the assignee(s) as mentioned above, we will

pay the benefit either to:

a) The nominee(s) appointed in accordance with Section 39 of the Insurance

Act, 1938 as amended from time to time, or

b) The executors / administrators or

c) The Legal heirs

d) Such person or persons as directed by a court of competent jurisdiction

in India

We will pay the appropriate benefits under the policy provided we are satisfied

that:

a) Benefits have become payable on the happening of an event as per the

policy terms and conditions,

b) Title of the claimant

c) Correctness of the information given by You in the proposal form

http://www.bloomberg.com/



PART F

General conditions

1. Age

We have calculated the Premiums under the Policy on the basis of the Age of

the Life Assured as declared by You in the Proposal Form. You are required to

submit the Age proof of the Life Assured and have the Age admitted, in case if

the Age was not admitted at the time of proposal. If the Age admitted (the

“Correct Age”) during the Policy term is found to be different from the Age

declared in the Proposal Form, We will take one of the following actions:

a) If the Correct Age of the Life Assured makes him ineligible for this

product, We will offer a suitable plan as per Our underwriting norms. If

You do not wish to opt for the alternative plan or if it is not possible for

Us to grant any other plan, We will cancel the Policy from inception and

refund the Premiums paid (without interest) under the Policy. The Policy

will terminate on the said payment.

b) If the Correct Age of the Life Assured makes him eligible for this Policy,

revised Premium will be payable as per the Correct Age from the next

Policy Anniversary.

The provisions of Section 45 of the Insurance Act, 1938 shall be applicable as

amended from time to time.

2. Nomination

Nomination will be as per Section 39 of the Insurance Act, 1938. Please refer

to Annexure II for details on this section.

3. Assignment

Assignment will be as per Section 38 of the Insurance Act, 1938. Please refer

to Annexure I for details on this section.

4. Incontestability

Incontestability will be as per Section 45 of the Insurance Act, 1938. Please refer

Annexure III for more details on this section.

5. Non-Disclosure & Fraud

Non-disclosure and Fraud will be as per Section 45 of the Insurance Act, 1938.

Please refer Annexure III for more details on this section.

6. Communication address

Our communication address is:

Address :Customer Service Desk

ICICI Prudential Life Insurance Company Limited


Unit No. 1A & 2A, RahejaTipco Plaza,

Rani Sati Marg, Malad (East),

Mumbai- 400097

Maharashtra.



Telephone/ Facsimile : 022 67100803 / 805

E-mail : [email protected]

We expect You to immediately inform Us about any change in Your address or

contact details.

7. Electronic transactions

All transactions carried out by You through Internet, electronic, call centres,

tele-service operations, computer, automated machines network or through

other means of communication will be valid and legally binding on Us as well

as You.

This will be subject to the relevant guidelines and terms and conditions as may

be made applicable by Us.

8. Jurisdiction

The Policy is subject to the terms and conditions as mentioned in the Policy

document and is governed by the laws of India. Indian courts shall have

exclusive jurisdiction over any and all differences or disputes arising in relation

to this Policy.

9. Legislative changes

All benefits payable under the Policy are subject to the tax laws and other

financial enactments as they exist from time to time. The Policy terms and

conditions may be altered based on any future legislative or regulatory

changes.

10. Payment of claim

Before payment of any claim under the policy, we will require the following

documents:

Claimant’s Statement

Original policy document

Death Certificate of the Life Assured issued by the local municipal authority

and medical authority

Copy of First Investigation Report (FIR), post mortem, panchnama, final

police investigation report etc. in case of death due to accident

Copy of all medical tests/ records, admission records, discharge summary,

prescriptions etc where death is not due to accident

Any other documents or information as may be required by the Company

for processing of the claim depending on the cause of the death

Claim payments are made only in Indian currency in accordance with the

prevailing Exchange control regulations and other relevant laws and

regulations in India.




PART – G

Grievance Redressal Mechanism & List of Ombudsman

1. Customer service

For any clarification or assistance You may contact Our advisor or call Our

customer service representative (between 9.00 a.m. to 9.00 p.m, Monday to

Saturday; excluding national holidays) on the numbers mentioned on the

reverse of the Policy folder or on Our website: www.iciciprulife.com.

Alternatively You may communicate with Us at the customer service desk

whose details are mentioned above.

For updated contact details, We request You to regularly check Our website.

a) Grievance Redressal Officer:

If You do not receive any resolution from Us or if You are not satisfied

with Our resolution, You may get in touch with Our designated

grievance redressal officer (GRO) at [email protected] or 1860 266

7766.

Address:

ICICI Prudential Life Insurance Company Limited,


Unit No. 1A & 2A, Raheja Tipco Plaza,


Mumbai- 400097

Maharashtra.

For GRO contact details please refer to the “Grievance Redressal”

section on www.iciciprulife.com.

b) Senior Grievance Redressal Officer:

If You do not receive any resolution or if You are not satisfied with the

resolution provided by the GRO, You may write to Our senior grievance

redressal officer (SGRO) at [email protected] or 1860 266 7766.

Address: ICICI Prudential Life Insurance Co. Ltd

ICICI Pru Life Towers, 1089,

Appasaheb Marathe Marg,

Prabhadevi, Mumbai-400025

For SGRO contact details please refer to the “Grievance Redressal”

section on www.iciciprulife.com.

c) Grievance Redressal Committee:

http://www.iciciprulife.com/





If You do not receive any resolution or if You are not satisfied with the

resolution provided by the SGRO, You may escalate the matter to Our

internal grievance redressal committee at the address mentioned

below:

ICICI Prudential Life Insurance Company Limited,


Unit No. 1A & 2A, RahejaTipco Plaza,


Mumbai- 400097

Maharashtra.

If you are not satisfied with the response or do not receive a response

from us within 15 days, you may approach the Grievance Cell of the

Insurance Regulatory and Development Authority of India (IRDAI) on the

following contact details:

IRDAI Grievance Call Centre (IGCC) TOLL FREE NO:155255

Email ID: [email protected]

You can also register your complaint online at

http://www.igms.irda.gov.in/

Address for communication for complaints by fax/paper:

Consumer Affairs Department

Insurance Regulatory and Development Authority of India

Sy. No. 115/1, Financial District, Nanakramguda, Gachibowli

Hyderabad –500 032, Telangana

Fax No: 91- 40 – 6678 9768

2. Insurance Ombudsman:

The Central Government has established an office of the Insurance

Ombudsman for redressal of grievances with respect to life insurance policies.

As per Insurance Ombudsman Rules, 2017, the Ombudsman shall receive and

consider complaints or disputes relating to:

a. delay in settlement of claims,

b. any partial or total repudiation of claims,

c. disputes over premium paid or payable;

d. misrepresentation of policy terms and conditions

e. legal construction of insurance policies in so far as the dispute relates

to claim;

f. policy servicing related grievances against insurers, their agents and

intermediaries;

g. issuance of policy not in conformity with proposal form submitted;

h. non-issuance of insurance policy after premium receipt; and

i. any other matter resulting from regulatory violation, related to issues

mentioned at clauses a. to f.



Manner in which complaint to be made

(1) Any person who has a grievance against an insurer, may himself or

through his legal heirs, nominee or assignee, make a complaint in

writing to the Insurance Ombudsman within whose territorial

jurisdiction the branch or office of the insurer complained against or the

residential address or place of residence of the complainant is located.

(2) The complaint shall be in writing, duly signed by the complainant or

through his legal heirs, nominee or assignee and shall state clearly the

name and address of the complainant, the name of the branch or office

of the insurer against whom the complaint is made, the facts giving rise

to the complaint, supported by documents, the nature and extent of the

loss caused to the complainant and the relief sought from the Insurance

Ombudsman.

(3) No complaint to the Insurance Ombudsman shall lie unless—

(a) the complainant makes a written representation to the insurer

named in the complaint and—

i. either the insurer had rejected the complaint; or

ii. the complainant had not received any reply within a period

of one month after the insurer received his representation; or

iii. the complainant is not satisfied with the reply given to him by

the insurer;

(b) The complaint is made within one year—

(i) after the order of the insurer rejecting the representation is

received; or

(ii) after receipt of decision of the insurer which is not to the

satisfaction of the complainant;

(iii) after expiry of a period of one month from the date of

sending the written representation to the insurer if the

insurer named fails to furnish reply to the complainant.

(4) The Ombudsman shall be empowered to condone the delay in such

cases as he may consider necessary, after calling for objections of the

insurer against the proposed condonation and after recording reasons

for condoning the delay and in case the delay is condoned, the date of

condonation of delay shall be deemed to be the date of filing of the

complaint, for further proceedings under these rules.

(5) No complaint before the Insurance Ombudsman shall be maintainable

on the same subject matter on which proceedings are pending before

or disposed of by any court or consumer forum or arbitrator.

We have given below the details of the existing offices of the Insurance

Ombudsman. We request You to regularly check our website at

www.iciciprulife.com or the website of the IRDAI at www.irdai.gov.in for

updated contact details.

Office of the

Ombudsman

Contact Details Areas of

Jurisdiction

AHMEDABAD Office of the Insurance Ombudsman,

2nd floor, Ambica House,

Gujarat, Dadra &

Nagar Haveli,



Office of the

Ombudsman


Jurisdiction

Near C.U. Shah College,

5, Navyug Colony, Ashram Road,

Ahmedabad – 380 014

Tel.:- 079-27546150/139

Fax:- 079-27546142

Email:[email protected]

Daman and Diu.

BENGALURU

Office of the Insurance Ombudsman,

Jeevan Soudha Building, PID No. 57-27-N-

19

Ground Floor, 19/19, 24th Main Road,

JP Nagar, 1st Phase Bengaluru – 560025

Tel.: 080 - 26652048 / 26652049

Email: [email protected]

Karnataka.

BHOPAL Office of the Insurance Ombudsman,

Janak Vihar Complex,

2nd Floor, 6, Malviya Nagar, Opp. Airtel,

Bhopal - 462 023

Tel.:- 0755-2769201/202

Fax:- 0755-2769203


Madhya Pradesh

and Chattisgarh.

BHUBANESHWAR Office of the Insurance Ombudsman,

62, Forest park,

Bhubneshwar – 751 009.

Tel.:- 0674-2596461/2596455

Fax:- 0674-2596429

Email:-

[email protected]

Orissa.

CHANDIGARH Office of the Insurance Ombudsman,

S.C.O. No. 101, 102 & 103, 2nd Floor,

Batra Building, Sector 17 – D,

Chandigarh – 160 017.

Tel.:- 0172-2706196/6468

Fax:- 0172-2708274


Punjab, Haryana,

Himachal Pradesh,

Jammu & Kashmir

and Chandigarh.

CHENNAI Office of the Insurance Ombudsman,

Fatima Akhtar Court,

4th Floor, 453, Anna Salai, Teynampet,

CHENNAI – 600 018.

Tel.:- 044-24333668/24335284

Fax:- 044-24333664

Email:- [email protected]

Tamil Nadu and

Pondicherry Town

and Karaikal (which

are part of Union

Territory of

Pondicherry).

DELHI Office of the Insurance Ombudsman,

2/2 A, Universal Insurance Building,

Asaf Ali Road,

New Delhi – 110 002.

Tel.:- 011-23237532/23239633

Delhi.










Office of the

Ombudsman


Jurisdiction

Fax:- 011-23230858


GUWAHATI Office of the Insurance Ombudsman,

’Jeevan Nivesh’, 5th Floor,

Nr. Panbazar over bridge, S.S. Road,

Guwahati – 781001(ASSAM).

Tel.:- 0361-2132204/2132205

Fax:- 0361-2732937


Assam, Meghalaya,

Manipur, Mizoram,

Arunachal Pradesh,

Nagaland and

Tripura.

HYDERABAD Office of the Insurance Ombudsman,

6-2-46, 1st floor, "Moin Court"

A. C. Guards, Lakdi-Ka-Pool,

Hyderabad - 500 004.

Tel.:- 040-65504123/23312122

Fax:- 040-23376599


Andhra Pradesh,

Telangana, Yanam

and part of the

Territory of

Pondicherry.

JAIPUR


Jeevan Nidhi – II Bldg., Gr. Floor,

Bhawani Singh Marg,

Jaipur - 302 005.

Tel.: 0141 -2740363

Fax: 0141 [email protected]

Rajasthan.

ERNAKULAM Office of the Insurance Ombudsman,

2nd Floor, Pulinat Bldg.,

Opp. Cochin Shipyard, M. G. Road,

Ernakulam - 682 015.

Tel.:- 0484-2358759/9338

Fax:- 0484-2359336


Kerala,

Lakshadweep,

Mahe-a part of

Pondicherry.

KOLKATA Office of the Insurance Ombudsman,

Hindustan Bldg. Annexe, 4, C.R. Avenue,

4th Floor, KOLKATA - 700 072.

TEL : 033-22124340/22124339

Fax : 033-22124341


West Bengal, Bihar,

Sikkim, Jharkhand

and Andaman and

Nicobar Islands.

LUCKNOW Office of the Insurance Ombudsman,

6th Floor, Jeevan Bhawan,

Phase-II, Nawal Kishore Road, Hazratganj,

Lucknow-226 001.

Tel.:- 0522-2231330/1

Fax:- 0522-2231310


Districts of Uttar

Pradesh :

Laitpur, Jhansi,

Mahoba, Hamirpur,

Banda, Chitrakoot,

Allahabad,

Mirzapur,

Sonbhabdra,

Fatehpur,

Pratapgarh,

Jaunpur,Varanasi,

Gazipur, Jalaun,











Office of the

Ombudsman


Jurisdiction

Kanpur, Lucknow,

Unnao, Sitapur,

Lakhimpur,

Bahraich, Barabanki,

Raebareli, Sravasti,

Gonda, Faizabad,

Amethi, Kaushambi,

Balrampur, Basti,

Ambedkarnagar,

Sultanpur,

Maharajgang,

Santkabirnagar,

Azamgarh,

Kushinagar,

Gorkhpur, Deoria,

Mau, Ghazipur,

Chandauli, Ballia,

Sidharathnagar.

MUMBAI


3rd Floor, Jeevan Seva Annexe,

S. V. Road, Santacruz (W),

Mumbai - 400 054.

Tel.:- 022-26106552/6960

Fax:- 022-26106052


Goa,

Mumbai

Metropolitan Region

excluding Navi

Mumbai & Thane

NOIDA


Bhagwan Sahai Palace, 4th Floor,

Main Road, Naya Bans, Sector 15

Noida Distt - Gautam Buddh Nagar

U.P - 201 301

Tel: 0120-2514250 / 2514251 / 2514253


State of Uttaranchal

and the following

Districts of Uttar

Pradesh:

Agra, Aligarh,

Bagpat, Bareilly,

Bijnor, Budaun,

Bulandshehar, Etah,

Kanooj, Mainpuri,

Mathura, Meerut,

Moradabad,

Muzaffarnagar,

Oraiyya, Pilibhit,

Etawah,

Farrukhabad,

Firozbad,

Gautambodhanagar,

Ghaziabad, Hardoi,

Shahjahanpur,

Hapur, Shamli,

Rampur, Kashganj,

Sambhal, Amroha,





Office of the

Ombudsman


Jurisdiction

Hathras,

Kanshiramnagar,

Saharanpur.

PATNA


1st Floor,Kalpana Arcade Building,,

Bazar Samiti Road,

Bahadurpur,

Patna 800 006.


Tel : 0612-2680952

Bihar,

Jharkhand

PUNE


Jeevan Darshan Bldg., 2nd Floor,

C.T.S. No.s. 195 to 198,

N.C. Kelkar Road, Narayan Peth,

Pune – 411 030.

Tel: 020-41312555


Maharashtra,

Area of Navi

Mumbai and Thane

excluding Mumbai

Metropolitan

Region.

mailto:[email protected].




Annexure I – Section 38 – Assignment and Transfer of Insurance Policies

Assignment or transfer of a policy should be in accordance with Section 38 of the

Insurance Act, 1938 as amended from time to time. The extant provisions in this regard

are as follows:

1. This policy may be transferred/assigned, wholly or in part, with or without

consideration.

2. An Assignment may be effected in a policy by an endorsement upon the policy

itself or by a separate instrument under notice to the Insurer.

3. The instrument of assignment should indicate the fact of transfer or assignment

and the reasons for the assignment or transfer, antecedents of the assignee and

terms on which assignment is made.

4. The assignment must be signed by the transferor or assignor or duly authorized

agent and attested by at least one witness.

5. The transfer of assignment shall not be operative as against an insurer until a

notice in writing of the transfer or assignment and either the said endorsement or

instrument itself or copy there of certified to be correct by both transferor and

transferee or their duly authorised agents have been delivered to the insurer.

6. Fee to be paid for assignment or transfer can be specified by the Authority through

Regulations.

7. On receipt of notice with fee, the insurer should Grant a written acknowledgement

of receipt of notice. Such notice shall be conclusive evidence against the insurer

of duly receiving the notice.

8. If the insurer maintains one or more places of business, such notices shall be

delivered only at the place where the policy is being serviced.

9. The insurer may accept or decline to act upon any transfer or assignment or

endorsement, if it has sufficient reasons to believe that it is

a. not bonafide or

b. not in the interest of the policyholder or

c. not in public interest or

d. is for the purpose of trading of the insurance policy.

10. Before refusing to act upon endorsement, the Insurer should record the reasons

in writing and communicate the same in writing to Policyholder within 30 days

from the date of policyholder giving a notice of transfer or assignment.



11. In case of refusal to act upon the endorsement by the Insurer, any person

aggrieved by the refusal may prefer a claim to IRDAI within 30 days of receipt of

the refusal letter from the Insurer.

12. The priority of claims of persons interested in an insurance policy would depend

on the date on which the notices of assignment or transfer is delivered to the

insurer; where there are more than one instruments of transfer or assignment, the

priority will depend on dates of delivery of such notices. Any dispute in this regard

as to priority should be referred to Authority.

13. Every assignment or transfer shall be deemed to be absolute assignment or

transfer and the assignee or transferee shall be deemed to be absolute assignee

or transferee, except

a. where assignment or transfer is subject to terms and conditions of transfer or

assignment OR

b. where the transfer or assignment is made upon condition that

i. the proceeds under the policy shall become payable to policyholder or

nominee(s) in the event of assignee or transferee dying before the insured

OR

ii. the insured surviving the term of the policy

Such conditional assignee will not be entitled to obtain a loan on policy or

surrender the policy. This provision will prevail notwithstanding any law or custom

having force of law which is contrary to the above position.

14. In other cases, the insurer shall, subject to terms and conditions of assignment,

recognize the transferee or assignee named in the notice as the absolute

transferee or assignee and such person

a. shall be subject to all liabilities and equities to which the transferor or assignor

was subject to at the date of transfer or assignment and

b. may institute any proceedings in relation to the policy

c. obtain loan under the policy or surrender the policy without obtaining the

consent of the transferor or assignor or making him a party to the proceedings

Disclaimer: This is a simplified version of Section 38 of the Insurance Act, 1938

as amended from time to time. The policyholders are advised to refer to The

Insurance Act, 1938 as amended from time to time for complete and accurate

details.



Annexure II – Section 39 – Nomination by policyholder

Nomination of a life insurance Policy is as below in accordance with

Section 39 of the Insurance Act, 1938 as amended from time to time. The

extant provisions in this regard are as follows:

1. The policyholder of a life insurance on his own life may nominate a person

or persons to whom money secured by the policy shall be paid in the event

of his death.

2. Where the nominee is a minor, the policyholder may appoint any person to

receive the money secured by the policy in the event of policyholder’s death

during the minority of the nominee. The manner of appointment to be laid

down by the insurer.

3. Nomination can be made at any time before the maturity of the policy.

4. Nomination may be incorporated in the text of the policy itself or may be

endorsed on the policy communicated to the insurer and can be registered

by the insurer in the records relating to the policy.

5. Nomination can be cancelled or changed at any time before policy matures,

by an endorsement or a further endorsement or a will as the case may be.

6. A notice in writing of Change or Cancellation of nomination must be

delivered to the insurer for the insurer to be liable to such nominee.

Otherwise, insurer will not be liable if a bonafide payment is made to the

person named in the text of the policy or in the registered records of the

insurer.

7. Fee to be paid to the insurer for registering change or cancellation of a

nomination can be specified by the Authority through Regulations.

8. On receipt of notice with fee, the insurer should grant a written

acknowledgement to the policyholder of having registered a nomination or

cancellation or change thereof.

9. A transfer or assignment made in accordance with Section 38 shall

automatically cancel the nomination except in case of assignment to the

insurer or other transferee or assignee for purpose of loan or against security

or its reassignment after repayment. In such case, the nomination will not

get cancelled to the extent of insurer’s or transferee’s or assignee’s interest

in the policy. The nomination will get revived on repayment of the loan.

10. The right of any creditor to be paid out of the proceeds of any policy of life

insurance shall not be affected by the nomination.



11. In case of nomination by policyholder whose life is insured, if the nominees

die before the policyholder, the proceeds are payable to policyholder or his

heirs or legal representatives or holder of succession certificate.

12. In case nominee(s) survive the person whose life is insured, the amount

secured by the policy shall be paid to such survivor(s).

13. Where the policyholder whose life is insured nominates his

a) parents or

b) spouse or

c) children or

d) spouse and children

e) or any of them

the nominees are beneficially entitled to the amount payable by the insurer

to the policyholder unless it is proved that policyholder could not have

conferred such beneficial title on the nominee having regard to the nature of

his title.

14. If nominee(s) die after the policyholder but before his share of the amount

secured under the policy is paid, the share of the expired nominee(s) shall

be payable to the heirs or legal representative of the nominee or holder of

succession certificate of such nominee(s).

15. If policyholder dies after maturity but the proceeds and benefit of the policy

has not been paid to him because of his death, his nominee(s) shall be

entitled to the proceeds and benefit of the policy.

16. The provisions of Section 39 are not applicable to any life insurance policy

to which Section 6 of Married Women’s Property Act, 1874 applies or has at

any time applied. Where nomination is intended to be made to spouse or

children or spouse and children under Section 6 of MWP Act, it should be

specifically mentioned on the policy. In such a case only, the provisions of

Section 39 will not apply.

Disclaimer: This is a simplified version of Section 39 of the Insurance Act, 1938

as amended from time to time. The policyholders are advised to refer to The

Insurance Act, 1938 as amended from time to time for complete and accurate

details



Annexure III – Section 45 – Policy shall not be called in question on the

ground of mis-statement after three years

Provisions regarding policy not being called into question in terms of

Section 45 of the Insurance Act, 1938, as amended by Insurance Laws

(Amendment) Act, 2015 are as follows:

1. No Policy of Life Insurance shall be called in question on any ground

whatsoever after expiry of 3 yrs from

a) the date of issuance of policy or

b) the date of commencement of risk or

c) the date of revival of policy or

d) the date of rider to the policy

Whichever is later.

2. On the ground of fraud, a policy of Life Insurance may be called in question

within 3 years from

a) the date of issuance of policy or

b) the date of commencement of risk or

c) the date of revival of policy or

d) the date of rider to the policy

whichever is later.

For this, the insurer should communicate in writing to the insured or legal

representative or nominee or assignees of insured, as applicable,

mentioning the ground and materials on which such decision is based.

3. Fraud means any of the following acts committed by insured or by his

agent, with the intent to deceive the insurer or to induce the insurer to issue

a life insurance policy:

a) The suggestion, as a fact of that which is not true and which the

insured does not believe to be true;

b) The active concealment of a fact by the insured having knowledge

or belief of the fact;

c) Any other act fitted to deceive; and

d) Any such act or omission as the law specifically declares to be

fraudulent.

4. Mere silence is not fraud unless, depending on circumstances of the case,

it is the duty of the insured or his agent keeping silence to speak or silence

is in itself equivalent to speak.

5. No Insurer shall repudiate a life insurance Policy on the ground of Fraud, if

the Insured / beneficiary can prove that the misstatement was true to the

best of his knowledge and there was no deliberate intention to suppress

the fact or that such mis-statement of or suppression of material fact are

within the knowledge of the insurer. Onus of disproving is upon the

policyholder, if alive, or beneficiaries.



6. Life insurance Policy can be called in question within 3 years on the ground

that any statement of or suppression of a fact material to expectancy of life

of the insured was incorrectly made in the proposal or other document

basis which policy was issued or revived or rider issued. For this, the

insurer should communicate in writing to the insured or legal

representative or nominee or assignees of insured, as applicable,

mentioning the ground and materials on which decision to repudiate the

policy of life insurance is based.

7. In case repudiation is on ground of mis-statement and not on fraud, the

premium collected on policy till the date of repudiation shall be paid to the

insured or legal representative or nominee or assignees of insured, within

a period of 90 days from the date of repudiation.

8. Fact shall not be considered material unless it has a direct bearing on the

risk undertaken by the insurer. The onus is on insurer to show that if the

insurer had been aware of the said fact, no life insurance policy would have

been issued to the insured.

9. The insurer can call for proof of age at any time if he is entitled to do so and

no policy shall be deemed to be called in question merely because the

terms of the policy are adjusted on subsequent proof of age of life insured.

So, this Section will not be applicable for questioning age or adjustment

based on proof of age submitted subsequently.

icici pru pos - life raksha you have a period of 15/30 ...€¦ · 2. cheques 3. demand drafts 4....

Documents